Sex-specific differences in myocardial glucose metabolic rate in non-diabetic, pre-diabetic and type 2 diabetic subjects.

Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Diabetes Mellitus, Type 2*/diagnosis ; Diabetes Mellitus, Type 2*/metabolism ; Diabetes Mellitus, Type 2*/epidemiology ; Prediabetic State*/metabolism ; Prediabetic State*/diagnosis ; Prediabetic State*/epidemiology ; Insulin Resistance* ; Myocardium*/metabolism ; Blood Glucose*/metabolism ; Glucose Clamp Technique*; Humans ; Male ; Female ; Middle Aged ; Sex Factors ; Adult ; Aged ; Biomarkers/blood ; Fluorodeoxyglucose F18 ; Positron-Emission Tomography ; Radiopharmaceuticals ; Insulin/blood ; Case-Control Studies ; Energy Metabolism

Background: Evidence has shown that women with type 2 diabetes (T2DM) have a higher excess risk for cardiovascular disease (CVD) than men with T2DM. Subjects with either T2DM or prediabetes exhibit myocardial insulin resistance, but it is still unsettled whether sex-related differences in myocardial insulin resistance occur in diabetic and prediabetic subjects.
Methods: We aimed to evaluate sex-related differences in myocardial glucose metabolic rate (MRGlu), assessed using dynamic PET with ¹⁸ F-FDG combined with euglycemic-hyperinsulinemic clamp, in subjects with normal glucose tolerance (NGT; n = 20), prediabetes (n = 11), and T2DM (n = 26).
Results: Women with prediabetes or T2DM exhibited greater relative differences in myocardial MRGlu than men with prediabetes or T2DM when compared with their NGT counterparts. As compared with women with NGT, those with prediabetes exhibited an age-adjusted 35% lower myocardial MRGlu value (P = 0.04) and women with T2DM a 74% lower value (P = 0.006), respectively. Conversely, as compared with men with NGT, men with T2DM exhibited a 40% lower myocardial MRGlu value (P = 0.004), while no significant difference was observed between men with NGT and prediabetes. The statistical test for interaction between sex and glucose tolerance on myocardial MRGlu (P < 0.0001) was significant suggesting a sex-specific association.
Conclusions: Our data suggest that deterioration of glucose homeostasis in women is associated with a greater impairment in myocardial glucose metabolism as compared with men. The sex-specific myocardial insulin resistance could be an important factor responsible for the greater effect of T2DM on the excess risk of cardiovascular disease in women than in men.
(© 2024. The Author(s).)

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Keywords: Cardiac 18F-FDG PET; Cardiovascular disease; Myocardial glucose metabolism; Prediabetes; Sex-differences; Type 2 diabetes

0 (Blood Glucose)
0 (Biomarkers)
0Z5B2CJX4D (Fluorodeoxyglucose F18)
0 (Radiopharmaceuticals)
0 (Insulin)

Date Created: 20240426 Date Completed: 20240427 Latest Revision: 20240429

20240429

PMC11055246

10.1186/s12933-024-02246-7

38671460